2021-05-10T10:35:24-05:00 2020-06-30 010494526 BAKER NEWMAN & NOYES LLC 650 ELM STREET SUITE 302 MANCHESTER NH 03101 990 2019-07-01 331003630 Elliot Professional Services Network Inc ELLI 6036638914 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 Joseph Felkner Current Executive VP and CFO 6036638914 2021-04-26 1 Nicholas E Porto P01310283 8002447444 2021-04-26 2019 2022-09-23 18:48:47Z William G Baxter 1070 Holt Avenue Unit 1 No 2100 Manchester NH 03109 59644285 0 X N/A X 2004 NH To promote the charitable, medical and scientific, and educational purposes of the Elliot Health System and its affiliated organizations through the employment of physicians and other professional personnel to provide medical care to those in need. 8 5 288 6 0 0 49946 1199065 60531470 58445220 -209 -3524 0 0 60581207 59640761 0 0 0 0 86076892 87075684 0 0 0 9266417 9376297 95343309 96451981 -34762102 -36811220 5651299 3286938 13224802 16911263 -7573503 -13624325 X The Elliot Professional Services Network is a group of highly specialized physicians and care providers, which are dedicated to the promotion of highest quality, compassionate and accessible health care. We realize the importance of each patient and each physician in the patient/physician relationship. We are guided by the desire to work within the larger Elliot Health System to create a healthy community. 0 0 94587179 0 58445220 To provide qualified professional personnel and make the services of such health care professionals available to such persons, including indigent persons, requiring medical care 94587179 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 31 0 1 288 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NH X Joseph Felkner 6033146628 360 Route 101 Unit 8 Bedford NH 03110 Elizabeth Sailhamer Soukup MD Physician 40.00 2.00 X 1123365 0 32239 Marina Feldman MD Physician 40.00 2.00 X 1028203 0 32305 William G Baxter President & CEO 2.00 51.00 X X 0 809867 140398 Robert C Parisien MD Physician 40.00 0.00 X 853448 0 31876 Lawrence M Hoepp MD Physician 40.00 1.00 X 845816 0 26217 Carl Fier MD Trustee (end 3/20) 41.00 1.00 X 840460 0 18651 Bryan Lawless MD Trustee 41.00 1.00 X 793485 0 32586 Bryan K Houseman DO Physician 40.00 0.00 X 742127 0 23488 Mark Integlia MD Trustee (end 3/20) 41.00 1.00 X 375486 0 26132 Michael S Turilli CFO 2.00 48.00 X 0 366319 22547 Christopher Calhoun MD Trustee 1.00 41.00 X 0 212151 43422 Loretta LC Brady Trustee 1.00 3.00 X 0 0 0 David Cuzzi Trustee 1.00 3.00 X 0 0 0 Michael Decelle Trustee 1.00 1.00 X 0 0 0 Stephen Langan Trustee 1.00 3.00 X 0 0 0 James J Tenn Esq Chair (begin 10/19) 1.00 4.00 X X 0 0 0 Paul W Hoff PhD Chair (end 10/19) 1.00 3.00 X X 0 0 0 6602390 1388337 429861 212 0 1 0 Elliot Hospital of the City of Mancheste 1 Elliot Way Manchester NH 03103 Management and Administration 1864802 Faith Minard ARNP 88 Blanford Place Bedford NH 03110 Nurse Practitioner Services 275422 Mary Hitchcock Memorial Hospital 1 Medical Center Drive Lebanon NH 037560001 Medical Services 253632 Jodi Carner Higgins 986 Dodge Hill Road Francestown NH 03043 Nurse Practitioner Services 153820 Medicus Surgery LLC 22 Roulston Road Windham NH 03087 Physician Services 116275 5 24843 769917 404305 1199065 Patient Services 621110 54381612 54381612 Other Medical Services 621110 4063608 4063608 58445220 3524 -3524 -3524 -3524 59640761 58445220 0 -3524 2086800 2086800 73266812 73266812 2413846 2413846 5797366 5797366 3510860 3510860 14162 14162 2182138 331498 1850640 1792 1792 1556460 1556460 1952162 1952162 7601 7601 9186 9186 159827 159827 Provision for Bad Debt 2072418 2072418 Medical Supplies 1320755 1320755 Medical Services 99796 99796 96451981 94587179 1864802 0 880 1180 1719218 1281618 3373152 1568337 222427 176248 1461126 1201571 335622 259555 5651299 3286938 9130635 9073714 4094167 7837549 13224802 16911263 X -7573503 -13624325 -7573503 -13624325 5651299 3286938 X -36811220 30760398 X X 0 1 X 1 0 X 26124 37392 34273 49946 1199065 1346800 59473877 57535250 57386055 60531470 58445220 293371872 59500001 57572642 57420328 60581416 59644285 294718672 0 0 0 294718672 133 127 53 313 133 127 53 313 59500134 57572769 57420381 60581416 59644285 294718985 1.00000 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1461126 1201571 259555 259555 Due to affiliates 1174774 Due to third party payors 2358169 Accrued pension obligations 3776242 Self Insurance Reserves and Other 528364 7837549 X 57520505 0 57520505 2120256 2120256 59640761 94374563 0 94374563 2077418 2077418 96451981 Part X, Line 2: Elliot Hospital, EPN, and EPS are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code, and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Management evaluated the Hospital's tax positions and concluded the Hospital has maintained its tax-exempt status, does not have any significant unrelated business income and had taken no uncertaion tax positions that require adjustment to the financial statements. Part XI, Line 4b - Other Adjustments: Net Periodic Pension Adjustment 42,838. Miscellaneous Expenses netted with Revenue on AFS 5,000. Provision for Bad Debt netted with Revenue on AFS 2,072,418. Part XII, Line 4b - Other Adjustments: Miscellaneous netted with Revenue on AFS 5,000. Provision for Bad Debt netted with Revenue on AFS 2,072,418. 0 1 0 0 0 0 0 1 0 Elizabeth Sailhamer Soukup MD Physician 1122225 0 0 0 1140 0 9725 0 22514 0 1155604 0 0 0 Marina Feldman MD Physician 926165 0 100000 0 2038 0 9725 0 22580 0 1060508 0 0 0 William G Baxter President & CEO 0 532468 0 257163 0 20236 0 117694 0 22704 0 950265 0 0 Robert C Parisien MD Physician 831771 0 0 0 21677 0 9725 0 22151 0 885324 0 0 0 Lawrence M Hoepp MD Physician 821307 0 0 0 24509 0 9725 0 16492 0 872033 0 0 0 Carl Fier MD Trustee (end 3/20) 833618 0 5000 0 1842 0 4125 0 14526 0 859111 0 0 0 Bryan Lawless MD Trustee 670965 0 102382 0 20138 0 9725 0 22861 0 826071 0 0 0 Bryan K Houseman DO Physician 741641 0 0 0 486 0 565 0 22923 0 765615 0 0 0 Mark Integlia MD Trustee (end 3/20) 350426 0 5000 0 20060 0 9725 0 16407 0 401618 0 0 0 Michael S Turilli CFO 0 307613 0 58006 0 700 0 5600 0 16947 0 388866 0 0 Christopher Calhoun MD Trustee 0 205119 0 6018 0 1014 0 26569 0 16853 0 255573 0 0 Part I, Line 3 The President & CEO of Elliot Professional Services Network is compensated by a related organization, The Elliot Hospital of the City of Manchester. The Hospital uses a compensation committee, an independent compensation consultant, Forms 990 of other organizations, compensation studies, and approval by the Board or a compensation committee to establish the compensation for the President & CEO. Part I, Line 4b 2019 contributions to William G. Baxter's 457(f) plan during the year totaled $107,969. The System maintains a defined benefit pension plan for certain employees, the Elliot Health System Pension Plan (the Plan). Effective July 1, 2006, the Plan was amended to close the Plan to employees hired after June 30, 2006. Eligible employees hired prior to July 1, 2006 are grandfathered under the Plan and will continue to accrue benefits as long as they remain at a participating System entity and in an eligible status. The System's funding policy is to contribute amounts to the Plan sufficient to meet minimum funding requirements set forth in the Employee Retirement Income Security Act of 1974, plus such additional amounts as might be determined to be appropriate from time to time. The Plan is intended to constitute a plan described in Section 414(k) of the Internal Revenue Code, under which benefits derived from employer contributions are based on the separate account balances of participants in addition to the defined benefits under the Plan. In calendar year 2019, no officers or employees of Elliot Hospital received defined contributions under the now-closed 414(K) plan. A defined benefit amount for Christopher Calhoun of $26,569, which includes the actuarial change in value for the year, is included in Schedule J, Part II, Column C and Form 990, Part VII-A, Column F as deferred compensation. Part I, Line 7 The Organization has adopted an incentive pay program that provides designated management employees an opportunity to earn a designated percentage of salary based on the achievement by the Organization of a number of critical success factors. The critical success factors are established annually by the independent executive compensation committee of the Board of Trustees with assistance from an independent national compensation consulting company. The maximum potential incentive payments under the plan are considered by the compensation consultant in ensuring that management compensation is reasonable. Form 990, Part VI, Section A, line 6 Elliot Hospital is the sole member of the reporting organization. Form 990, Part VI, Section A, line 7a Elliot Hospital, the sole member of the reporting organization, has the right to ratify the election of all Board members of Elliot Professional Services Network. Additionally, representatives from the sole member share equal representation on the Board of Trustees with the filing organization. Form 990, Part VI, Section A, line 7b The sole member, Elliot Hospital, has the right to the following governance decisions: approval of Elliot Professional Services Network's annual budget, approval of Bylaws and Articles of Organization and amendments of same, and approval of strategic plans. Form 990, Part VI, Section B, line 11b The completed Form 990 is presented to the full Board prior to filing. Board members can review the draft and bring any questions forward for discussion prior to filing. Form 990, Part VI, Section B, line 12c Officers, directors and key employees are required annually to sign a conflict of interest form which requires reporting any potential conflict of interest arrangements with the organization. Form 990, Part VI, Section B, line 15 The compensation committee of the board utilizes outside compensation consultants to evaluate the salaries for the CEO, CFO, and COO. The consultants utilize their internal data along with national and local benchmark data from the industry to develop salary levels. Recommendations of the consultant are reviewed by the compensation committee, who recommends compensation levels to the full Board for approval. An outside consulting firm is also used by the organization to review the compensation of the remainder of the Vice Presidents. Again, national and local benchmarks for salaries are consulted to determine salary levels for these positions. Form 990, Part VI, Section C, line 19 Each of these documents is filed with the New Hampshire Secretary of State and is available upon request. Form 990, Part XI, line 9: Transfers from affiliates 31,835,000. Net periodic pension adjustment -1,074,602. Form 990, Part XII, Line 2c: The audit process has not changed from the prior year. Elliot Health System 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509911 Management NH 501(c)(3) Line 12b, II SolutionHealth 0 Elliot Health System Professional & General LIT 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 016217452 Insurance Trust NH 501(c)(3) Line 12a, I Elliot Hospital 0 Elliot Hospital 1 Elliot Way Manchester NH 03103 020232673 Medical Services NH 501(c)(3) Line 3 Elliot Health System 0 Elliot Hospital Associates 1 Elliot Way Manchester NH 031033599 026006214 Auxiliary NH 501(c)(3) Line 12d, III-O N/A 0 Elliot Physician Network 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020509589 Physician Services NH 501(c)(3) Line 3 Elliot Hospital 0 Foundation Medical Partners Inc 8 Prospect Street Nashua NH 03060 020456218 Physician Services NH 501(c)(3) Line 10 Southern New Hampshire Health System 0 Legacy Trust of Southern New Hampshire Health Inc 8 Prospect Street Nashua NH 03060 844779887 Fundraising NH 501(c)(3) Line 7 Southern New Hampshire Health System 0 Mary and John Elliot Charitable Foundation 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512229 Fundraising NH 501(c)(3) Line 7 Elliot Health System 0 SolutionHealth 360 Route 101 Unit 8 Manchester NH 03110 830741190 Supporting Organization NH 501(c)(3) Line 12a, I N/A 0 Southern New Hampshire Health System 8 Prospect Street Nashua NH 03060 020509221 Medical Services NH 501(c)(3) Line 12b, II SolutionHealth 0 Southern New Hampshire Medical Center 8 Prospect Street Nashua NH 03060 020483054 Medical Services NH 501(c)(3) Line 3 Southern New Hampshire Health System 0 VNA Community Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020396549 Nursing Services NH 501(c)(3) Line 7 Elliot Health System 0 VNA Home Health and Hospice Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020222241 Home Care and Hospice NH 501(c)(3) Line 10 Elliot Health System 0 VNA of Manchester & Southern NH Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395296 VNA Holding Company NH 501(c)(3) Line 12b, II Elliot Health System 0 VNA of Southern New Hampshire Foundation 1070 Holt Avenue Unit 1 Suite 1400 Manchester NH 03109 223313877 Supporting Organization NH 501(c)(3) Line 12b, II Elliot Health System 0 VNA Personal Services Inc 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020395295 Private Health and Homemaker Services NH 501(c)(3) Line 10 Elliot Health System 0 Elliot Common Trust Fund LLC 1 Elliot Way Manchester NH 03103 203653624 Investments NH N/A Elliot Health System Holdings & Subsidiaries 1070 Holt Avenue Unit 1 Suite 2100 Manchester NH 03109 020512224 Management NH N/A C 0 0 0 1 0 0 0 0 0 1 0 1 0 1 0 1 1 1 0 0 The Elliot Hospital of the City of Manchester K 985567 Cash Value The Elliot Hospital of the City of Manchester P 14917056 Cash Value The Elliot Hospital of the City of Manchester Q 6001018 Cash Value